Difference between revisions of "Paresthesia"

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{{DiseaseDisorder infobox |
  Name        = Paresthesia |
  ICD10      = {{ICD10|R|20|2|r|20}} |
  ICD9        = {{ICD9|782.0}}, {{ICD9|355.1}} |
{{Editor Help}}
'''Paresthesia''' or '''paraesthesia''' (in [[British English]]) is a [[sensation]] of [[Wiktionary:tingling|tingling]], [[Wiktionary:pricking|pricking]], or '''[[Wiktionary:numbness|numbness]]''' of a [[person]]'s [[skin]] with no apparent long-term physical effect, more generally known as the feeling of '''pins and needles''' or of a [[human limb|limb]] being "asleep" (but not directly related to the phenomenon of [[sleep]]). Its manifestation may be transient or chronic.
==Chronic condition==
Chronic paresthesia indicates a problem with the functioning of [[neuron]]s. This malfunction, which is especially common in older individuals, is often the result of poor [[Circulation (physiology)|circulation]] in the limbs (such as in peripheral vascular disease), which may be caused by [[atherosclerosis]] — the build up of [[plaque]] on [[artery]] walls. Without a proper supply of [[blood]] and [[nutrients]], nerve cells can no longer adequately send signals to the [[brain]]. Because of this, paresthesia can also be a symptom of [[vitamin]] deficiency and [[malnutrition]], as well as [[metabolism|metabolic]] disorders like [[Diabetes mellitus|diabetes]], [[hypothyroidism]], and [[hypoparathyroidism]].
Irritation to the nerve can also come from [[inflammation]] to the surrounding tissue. Joint conditions such as [[rheumatoid arthritis]] and [[carpal tunnel syndrome]] are common sources of paresthesia.
Another cause of paresthesia, however, may be direct damage to the nerves themselves, or [[neuropathy]], which can stem from [[injury]] or [[infection]] such as [[Lyme disease]], or which may be indicative of a current [[neurological disorder]]. Chronic paresthesia can sometimes be symptomatic of serious conditions, such as a [[transient ischemic attack]], a [[brain tumor]], [[motor neurone disease]], or [[autoimmune disorder]]s like [[multiple sclerosis]] or [[lupus erythematosus]]. A diagnostic evaluation by a [[medical doctor|doctor]] is necessary to rule these out.
Paresthesiae of the [[mouth]], hands, and feet are common, transient symptoms of the related conditions of [[hyperventilation syndrome]] and [[panic attack]]s.
{{SK}} Paraesthesia
== [[Paraesthesia overview|Overview]] ==
Other known causes of paresthesia (aside from pressure on the affected area):
== [[Paraesthesia historical perspective|Historical Perspective]]==
*[[Anticonvulsant]] [[medication|drugs]] such as [[topiramate]], [[sulthiame]], and [[acetazolamide]]
*[[Fabry disease]]
*[[Heavy metals]]
*[[Lidocaine]] poisoning
*[[Multiple sclerosis]]
*[[Radiation poisoning]]
*Withdrawal from certain [[SSRI]]s, such as [[Paroxetine]]
*[[Vitamin B12]] deficiency
*[[Immune]] deficiency, such as [[Chronic inflammatory demyelinating polyneuropathy]] (CIDP)
*[[Guillain-Barre Syndrome]] (GBS)
== Diagnosis ==  
== [[Paraesthesia pathophysiology|Pathophysiology]] ==
== History and Symptoms ===
== [[Paraesthesia causes|Causes]] ==
*A complete physical exam and history is necessary
:*Anatomic distribution
:*Personal history
:*Negative symptoms (weakness, pain etc.)
== Differential Diagnosis of Causes {{PAGENAME}}==
== [[Paraesthesia risk factors|Risk Factors]] ==
*Acute idiopathic polyneuritis
*Alcoholic neuropathy
*[[Alcoholism]] and alcohol withdrawal
*[[Amyotrophic lateral sclerosis]]
*[[Brain tumor]]
*[[Carpal Tunnel Syndrome]]
*Cerebrovascular insult
*[[Charcot-Marie-Tooth Syndrome]]
*Collagen vascular disease
*[[Diabetes Mellitus]]
*Entrapment neuropathy
*[[Guillain-Barre Syndrome]]
*Head trauma
*Hereditary motor neuropathies
*[[Herpes Zoster]]
*[[Lyme Disease]]
*[[Multiple Sclerosis]]
*Nerve compression
*Peroneal palsy
*[[Polyarteritis Nodosa]]
*[[Sjogren's Syndrome]]
*Systemic sclerosis
*Tarsal tunnel
*[[Throacic outlet syndrome]]
*[[Trigeminal neuralgia]]
*Ulnar entrapment
*[[Vitamin B12 deficiency]]
== [[Paraesthesia natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
Treatment should be decided by a [[neurologist]].  Medications offered can include [[prednisone]], intravenous [[gamma globulin]] (IVIG) and [[anticonvulsants]] such as [[gabapentin]] or [[gabitril]], amongst others.
== Diagnosis ==
In some cases, rocking the head from side to side will painlessly remove the "pins and needles" sensation in less than a minute. A tingly hand or arm is often the result of compression in the bundle of nerves in the neck. Loosening the neck muscles releases the pressure. Compressed nerves lower in the body govern the feet, and standing up and walking around will typically relieve the sensation. <ref>http://health.msn.com/menshealth/articlepage.aspx?cp-documentid=100119940&GT1=7538</ref>
[[Paraesthesia history and symptoms|History and Symptoms]] | [[Paraesthesia physical examination|Physical Examination]] | [[Paraesthesia laboratory findings|Laboratory Findings]] | [[Paraesthesia chest x ray|Chest X Ray]] |[[Paraesthesia CT|CT]] | [[Paraesthesia MRI|MRI]] | [[Paraesthesia other imaging findings|Other Imaging Findings]] | [[Paraesthesia other diagnostic studies|Other Diagnostic Studies]]
An arm that has "fallen asleep" may also be "awoken" more quickly by clenching and unclenching the fist several times; the muscle movement increases blood flow and helps the limb return to normal.
== Treatment ==
[[Paraesthesia medical therapy|Medical Therapy]] | [[Paraesthesia surgery|Surgery]] | [[Paraesthesia primary prevention|Primary Prevention]]
==Case Studies==
:[[Paraesthesia case study one|Case #1]]
==External links==
==External links==
* {{NINDS|paresthesia}}
* {{NINDS|paresthesia}}
{{Symptoms and signs}}
[[Category:Signs and symptoms]]
[[Category:Primary care]]
{{WikiDoc Help Menu}}
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Latest revision as of 18:47, 7 February 2013